Impact of Adding Protein Supplementation to Exercise Training on Lean Body Mass and Muscle Strength in Burn Patients.

Protein catabolism is a common complication after burn injury, leading to a loss of muscle mass and a decrease in muscle strength. The present study was aimed to evaluate the efficacy of combining exercise training with protein supplementation on lean body mass and muscle strength in patients with severe burn. Sixty participants with severe burn >30% of TBSA were randomly distributed into four equal groups of 15 participants per group. Group A (Exercise and Protein) received oral protein supplementation (Inkospor X-TREME; 1.5-2.0 g/kg/d), exercise program, and traditional burn care; group B (Protein) received oral protein supplementation and traditional burn care; group C (Exercise) received exercise program and traditional burn care; and group D (Control) received traditional burn care. Lean body mass was measured using dual-energy x-ray absorptiometry, whereas muscle strength was measured using Biodex 3 Dynamometer System before treatment and 12 weeks after treatment. A significant increase in lean body mass was found in group A compared with that of group B, group C, and group D post-treatment (P < .001). Also, a significant increase was recorded in peak torque of group A compared with that of group B, group C, and group D post-treatment (P < .001). Exercise training can significantly increase lean body mass and peak torque. Protein supplementation can significantly increase lean body mass but cannot significantly increase muscle strength, whereas protein + exercise group has a great impact on lean body mass and muscle power than exercise group and protein group in burn patients.

Does High-Frequency Chest Wall Oscillation Have an Impact on Improving Pulmonary Function in Patients With Smoke Inhalation Injury?

Smoke inhalation results in bronchospasm of the trachea, increasing secretion of mucus, casts formation, and improvement of blood flow of the airway. High frequency chest wall oscillation is a common modality used for clearing mucus secretion in patients suffering from hypersecretion of thick mucus and used also to help cough clearance. This study aimed to detect the effect of high frequency chest wall oscillation in improving pulmonary function in burn patients suffering from smoke inhalation. Sixty smoke inhalation injury patients were randomly distributed into two groups of equal size. Group A: received high frequency chest wall oscillation and conventional chest physical therapy (breathing exercises, early ambulation, and cough training) thrice per week for 8 weeks. Group B: received traditional chest physical therapy (breathing exercises, early ambulation, and cough training) thrice per week for 8 weeks. Pulmonary function test (forced vital capacity, forced expiratory volume in the first second and peak expiratory flow rate) was measured at enrollment and after 8 weeks by using spirometer. Pulmonary function increased significantly posttreatment when compared with that pretreatment in groups A and B (P > .001). Also, they increased significantly in group A compared with that of group B posttreatment (P > .05). High-frequency chest wall oscillation have an impact on improving pulmonary function and should be handled to be a part of the pulmonary rehabilitation plan for smoke inhalation injury patients.

Cardio respiratory response: Validation of new modifications of Bruce protocol for exercise testing and training in elite Saudi triathlon and soccer players.

The Bruce protocol is the traditional method used to assess maximal fitness level, although it may have limitations, such as its short duration and large work rate increases, with very high levels of exertion that consist of speed/incline combinations. Modifications have been added to elicit similar maximal fitness achievements. The authors of this experimental trial have proposed a new treadmill protocol that allows optimal test duration in conjunction with peak oxygen consumption 'VO2max', and with appropriate patient comfort and safety during both exercise testing and training. SUBJECTS: Twenty-two elite Saudi players, comprising eleven Saudi triathlon athletes, and eleven Saudi elite soccer players, BMI, body fat mass percentage, body fat free mass percentage. cardiovascular parameter; including, absolute and relative "VO2max" as well as maximal heart rate "HR max", were assessed during a graded treadmill running modified protocol, using a Quark Cardio Pulmonary Exercise Testing Unit (CPET). RESULTS: Descriptive statistics were used to obtain the anthropometric characteristics, including comparisons between the means, independent sample T-test and a regression analysis, to test the association of the protocol duration and the corresponding, dependent variables. CONCLUSIONS CLINICAL RELEVANCE: It is often difficult to achieve a high cardiorespiratory response, VO2max, without an association to high values of HR max, and peak perceived exertion. This may lead to cardiovascular risk. Our new modifications can provide a practical, valid alternative protocol to be used comfortably both during exercise testing and training, rather than performance testing only, to achieve high VO2max with minimal cardiovascular stress.